Medical writers do things you never heard of
Fast, good or cheap? Your research or mine?
60 letters, 10 interviews, 6 accounts

$750 for a press release: How Wendy built a bid

NEW YORK--Medical writers can be like children playing at the seashore, sometimes picking up a prettier pebble, but unaware of the vast ocean before them.

Brian Bass
shared his experiences on the vast ocean of medical writing at the Editorial Freelancers Association (EFA) medical affinity group meeting here on 23 September, in his presentation, "Bringing in--and keeping--business."

"Every person in this room has found a niche," said Bass, who works as president of Bass Advertising & Marketing, Inc., Robbinsville, NJ. "But every one of us has only scratched the surface."

"Medical writing has been very, very good to me," cracked Bass, who was president of the American Medical Writers Association (AMWA) Delaware Valley Chapter last year. (Like all AMWA members, his Freelance Directory entry is on-line (at least for members) at
AMWA's new web site
.

Bass' triad

There are 3 components to medical writing, said Bass.

First, identifying what's out there. We should be aware of the whole universe of medical writing and editing.

Second, getting the business. Bass described his marketing techniques.

And third, figuring out what to do when you've got it. For that, he turned the meeting over to
Wendy J. Meyeroff
, chair of the EFA medical group, who gave a presentation on negotiating prices.

The universe of medical writing

"The best way to start is to be aware of what's out there," said Bass. Medical writing comes in many categories. First he described the types of writing. Then he described the companies that do it, who are typically diversified advertising agencies that work for pharmaceutical companies. Then he described his marketing and working techniques, which he developed in a learning curve of about 2 years after being laid off from an ad agency in one of the many troughs of that cyclic business. In library directories, he found 60 companies, sent 60 letters, got 10 interviews and 6 accounts. Marketing is "terribly tedious," but now the phone rings and he turns down work (which he passes on to other writers). He doesn't sign a contract, but he does build a "grief factor" into his bids if clients don't pay in a reasonable time.

The only way to negotiate a price is after careful preparation, said Meyeroff. When the client calls, it's too late. The way to figure out what to charge is to find out what your fellow writers are charging for the same work. You can't get specific numbers, but you can get a general sense. Then you adjust it up or down for the job--the kind and amount of work, what you do for the job and what the client does, how tight the deadline is, how much is the client good for, and how difficult are they to work with and collect bills from.

If you can, stall--to give yourself time to think. Ask the client to describe the job in more detail, so you'll get a sense of what you're getting into. Even the best writers can't negotiate off the top of their heads, said Meyeroff.

The EFA rate guide gives the range and median rates for many types of writing, said Meyeroff. "Most of the people I know are making $75 and $100 an hour plus."

The going rate might be twice what you're charging, and you could be in for a pleasant surprise when you raise your rates for the next bid. Your client could say, "Great. That sounds reasonable." Actually, that's a bad sign, said Meyeroff. It means you might have underbid. What you should be hearing is, "That's a little high." You should start high and zigzag down. You might work for less if you have a special reason. But otherwise, recognize a situation where they're paying so little money, for so much work, that the job isn't worth it. Know when to say "No," she said in her
7-step guide
.

Types of writing

First Bass broke the medical writing market down by type of writing:

Regulatory writing. This is the only medical writing that Bass would not do. It is "intensely scientific," he said, drafting reports, known as Investigative New Drug Applications (INDAs) from pharmaceutical companies or Contract Research Organizations (CROs) to the Food and Drug Administration. It costs $200 to $300 million to bring a new drug to market. Reports must be written in a strict format and reviewed by layers of lawyers, scientists and company officials. "There is a lot riding on that report," he said. "It can be a very nice gig. It tends to tie you up for 6 months to 2 years or more, generally on-premises."

Scientific writing. This can be monographs, journal articles, white papers, or drafting abstracts of clinical trials, said Bass. It can also be fairly scientific and technical.

Promotional writing. This is a very broad category, said Bass. It includes "all the promotional material given to the sales force to help them detail physicians." It includes direct mail, journal articles, and monographs. A company might spend $30,000 on a monograph targeted at doctors or hospital pharmacists. They're willing to spend a lot of money on anything that will make a $200 to $300 million new drug launch more successful. Sometimes pharmaceutical companies want "reprint carriers," which are 2-pocket folders that carry copies of journal articles and summaries of the articles in quick bulleted points. "It enables the sales rep to detail to the doctor while they're walking down the hallway," said Bass.

Educational material. This is another very broad category. It can include monographs and CME material, usually in print but also in CD-ROM or other media. You can be educating the doctor, or the sales reps, on a new product or therapeutic area.

Patient education is another category of educational (and promotional) material. The media can be brochures, posters in a doctor's office or on the bus, TV, radio, or the new digital media.

Pharmaceutical companies and CROs also use writers for in-house communications, said Bass. They use newsletters to inform their own employees what's going on inside the company. There are sales training newsletters, and newsletters that go out to the customers.

Who does it?

"Client" is a relative term. You have clients, who are usually communications companies, and they have clients, who are typically pharmaceutical companies or CROs. Sometimes you can work for the final client directly.

In your marketing, you will be targeting clients who now call themselves "communications" or "medical education" companies, said Bass. "Advertising agency" is not a good term, although many of them are advertising agencies that diversified.

The communications companies are very broad-based. "These companies are doing everything," said Bass. The advantage of that is that they are diversified. Bass has several communications companies as clients, and each company has several clients in turn.

Pharmaceutical companies and CROs are the traditional clients of medical writers, said Bass. But writers tend to forget about the other organizations that need medical writers. Bass has done a lot of work for medical device manufacturers, on hip replacement and blood diagnosis, for example. "They do a ton of brochure work," for conferences and direct mail, he said. "Don't limit yourself to pharmaceuticals."

Medical writing tends to be specialized, said Bass, although "pharmacoeconomics drives all the markets." There are nuances that make every market different

The other day, said Bass, "I got a phone call, from somebody who was looking for a writer who specialized in dental radiology." It seemed like a peculiarly narrow specialty, he said (although another writer at the meeting pointed out that dental radiation was the one procedure that everyone in the room had undergone). Bass himself got started in animal health.

Small world

"The pharmaceutical medical writing industry is for all of its size an incredibly small place," said Bass. "Every 2-3 years, all of my clients shuffle. One person at every one of my clients moves to another one of my clients." They want to bring their own people to the job, "and you're one of them," he said.

It's also an insulated world. Bass sees this as an advantage. "I don't have to deal with clients," he said. "You want me to do it again? Sure, I'll do it. It'll cost you again."

There is a downside, "which has not been limiting for me," said Bass. "They've got to mark up your work," often 100%, so you can't make as much.

Turnaround is fast. As is well known in the industry, "communications companies only call a freelance writer when they're a day late and a dollar short," said Bass. "If I had more than 3 weeks to do a monograph from scratch, that would be a lot," he said. "I've done them in a week."

You don't want to say no. "If you tell them you can't do it, they'll find someone else," and they might wind up being happy with someone else, said Bass. "That's why freelance writers work 60 and 70-hour weeks."

"I spend more weekends and evenings than I like to think about," said Bass, "and that's because I don't want to turn work down."

But if he can't do it, "I want to refer them to somebody else," said Bass. "I want to be part of the solution rather than be part of the problem."

Getting the business

Because Bass got his background in an advertising agency, "I didn't have a lot to offer as a medical writer," he said. "I had to aggressively market myself to fill the gap from the agency work." He used a resume, because he thought a brochure looked "too presumptuous."

One of the important stops is the library. Useful sources were the Red Book of Advertisers (in the section, "Specialized medical advertising agencies) and
Med Ad News
(and see their
help-wanted ads)
and
Medical Marketing & Media
. You can look up "Advertising agencies" in the yellow pages to find the smaller ones.
Jack O'Dwyer's PR Firms Database is a good list of major medical and other PR firms.
Crain's New York Business
has a calendar of upcoming events every week, and every year has a directory of advertising agencies, which includes health care agencies. The magazine Medical Marketplace includes a yearly directory of medical education.

The Pharmaceutical Research and Manufacturers of America (PhRMA)
publishes a "Reporter's Handbook for the Prescription Drug Industry," which includes listings for about 100 members and affiliates, and most usefully has listings of the public relations departments of the major pharmaceutical companies. (Because they list the home numbers of PR executives, for the benefit of reporters from major news media on deadline, the PhRMA likes to limit the circulation to news reporters, not medical writers looking for work.)

"I could do business by fax, phone and email exclusively," said Bass, "but I find it better to have face-to-face relationships."

On-site, "You can shuffle down the hall" from the person you're working with to another person in the same company, said Bass. You bump into people in the hallways who can lead to more work. You can do "networking within companies." A person in one department will recommend you, or at least tell you who else is hiring, in another department.

Here's my plan

Bass made a list of 60 companies. He called them all, with the question, "Who's the person who hires freelancers?" With his resume, he sent a cover letter, which was a personalized form letter.

"The letter was meant to introduce myself, and convince that person that they needed freelance help, and that they couldn't afford not to talk to me," said Bass.

"Out of 60 letters I got 10 interviews and 6 accounts."

He sends out letters every 3 months, followed up with phone calls. It's "terribly tedious," said Bass.

The message is, "Since you heard from me last, this is what I've been doing."

"The time to look for work is not when you need it," said Bass. "It took me 2 years to get to the point where the phone rings."

A handshake

"I have never worked with a contract," said Bass. "I do most of my business on a handshake and a relationship." He's only been bitten 2 times. (Handshake deals are traditional but unusual now. Other freelancers commented that they try to get 50% up front, and usually get at least 1/3.)

The more common problem is clients who pay late, said Bass. For them, he builds in a "grief factor" into his next bid, of 20%, 30%, 50% or "sometimes double." (Doubling your fee is a good way of getting rid of a client you don't want, many freelancers agree. Either way, you get what you want. Even a difficult job can begin to look good at twice your normal rate.)

The communications companies usually pay within 45 days after billing. "One client went to 180 days on a couple of bills." The smaller companies can't handle the float while they wait for the pharmaceutical company to pay them. "If their major client is a drug that is suddenly throttled by the FDA," they can have trouble paying their bills.

"I provide a really detailed estimate," said Bass. "This is what you're going to give me." The estimate sets forth "my expectations of the client and the client's expectation of me."

When the client says, "I just got a truckload of new reference materials," Bass says, "That's fine. let's renegotiate."

"The invoice sounds exactly like the estimate," said Bass. Sometimes he will throw in something extra for free, and he makes sure to note that on the invoice.

"The invoice is the last marketing tool," said Bass, "an opportunity to show the client how much value I've given them for the money."

Wendy Meyeroff: Negotiating Strategies

Meyeroff handed out a 7-step guide to negotiating.

You're allowed to hate this whole process. You just can't let it paralyze you.

"99% of the people I know in this field are not natural born sales people," said Meyeroff.

Charlie Client calls. Charlie has 2 questions: First, "Are you available to do X?" That's the easy question, said Meyeroff. Either you can do it or you can't.

Second, "What will you charge me?" That's the hard question. The client and the writer go through an Alphonse-Gaston routine. "What is your budget?"

"Tradition says that the first one who mentions a number in the negotiation loses," said Meyeroff, "but that doesn't have to be true if you follow a few simple steps."

Do some pricing homework. Find out what other communication pros are charging for the work you're doing (or seeking to do.)

"I am constantly meeting people who do not know the going rate for the work they're doing," said Meyeroff. You may not be able to get absolute numbers, of how many dollars a page--but you can get a general idea of what people on your level are making for, say, a 6-page brochure on pool filters, or kidney dialysis.

For a particular kind of work, Meyeroff found out a few years ago that one EFA medical writer with extensive experience was making $600 a day, whereas Meyeroff was getting $300. "I'm not ready to move from $300 to $600," she said to herself. Still, she bucked up her courage and for the next job of that type asked for $450 a day. "Son of a gun," she said. "I got $450."

One of the best sources of pricing information is the EFA "Rates and Business Practices Survey," said Meyeroff. (The Survey is included free with membership, or $20 + $3 postage for non-members. See my review
here
.)

The survey was last published in 1996. "Knock up the price 10% a year for inflation," said Meyeroff.

The EFA rate survey gives a range of rates and a median. "How close are you to the median?" said Meyeroff. "You're not trying to get to the top," she said. You don't want to overprice yourself out of the market.

For example, the survey reported $25-65 an hour for medical editing in 1996, with $40 as the median. "$25 an hour is the absolute minimum if you're a novice," said Meyeroff.

Adjust the prices according to the client. Merck or Pfizer can pay more than the American Cancer Society, said Meyeroff. If during the course of negotiations, you see the client is difficult to work with, "jack up the price 50%."

Given the rate, there are 3 factors that go into the estimate, said Meyeroff: (1) What is the project? (2) What is the length? (3) What is the deadline? You can have it good, fast or cheap--pick 2 out of 3. If you have to work in-house, you should charge more, because when you're away from your office you will lose other business.

Try NOT to talk off the top of your head. If you can, STALL! (Even if it's just for a few minutes.)

Lewis referred a client to Meyeroff. At 1pm, she got a call from the client. He needed 2 press releases by close of business. Meyeroff's response: "I need to crunch some numbers and call you back in 20 minutes."

His response: "No, I need an answer right away."

So she stalled. First she got a better idea of what he really wanted. "Do you really need it at 6, or can I get it to you first thing in the morning?" His response: First thing next morning is fine.

Then she got a better idea of the job: He would fax in 12 pages of background. There was no research, no interviews.

Finally they came down to the bottom line: "What will you charge me?"

The press releases were 1 page apiece, 300 words a page. Meyeroff figured $1 a word, with a little extra for the time crunch--$750.

"I should have said $1,000," said Meyeroff. A friend said that she should have charged $1,500, "but that's a little on the high side."

You may shoot yourself in the foot sometimes, but if you have done your homework, "it's a flesh wound, not an amputation."

The story took "maybe 7 hours tops," said Meyeroff. "I can feed my family on $100 an hour."

Sometimes you adjust the fee down when you really want the job--but not after first developing a number that's MORE than you want, so there's room to move down. Meyeroff got a call from a major New York hospital. The person described the job, and asked Meyeroff what she would charge. "$1,000," she recalled. "I didn't expect to get it."

The response was, "That's a little high. How about $750?"

"She was undoubtedly waiting for me to counter higher, but I always wanted to put this hospital on my resume," said Meyeroff. "Besides, $750 was the number I originally was aiming for," so she didn't do the zig-zag.

Other factors that affect the bid are:

Research. Do you do the research or do they?

Interviews. Do you use their sources or do you have to get your own sources? You can post a request to Profnet, Meyeroff added, and you will get 500 responses from people claiming, "I'm an expert."

In-house or at home? If you have to work on their premises 5 days a week for the next 2 months, it will hurt your work for other clients.

Your experience. If you've already done a job like it, you know what the obstacles are.

Fellow freelancers can help, said Meyeroff. If you've never done a job like that before, "Open the EFA or AMWA directory and call the people who do that work. People are amazingly generous. In 20 years in this business I have only met one person who would not help me out."

You call Charlie back with the figure and he says, "Great." Either you're right on target, said Meyeroff, or you've undercut yourself.

"Keep a time chart," said Meyeroff. $6,000 sounds great, but if you took 100 hours, it's not so great. "Most of the people I know are making $75 and $100 an hour plus."

Meyeroff believes in investing in technology. If you're spending a lot of time on Internet, you should invest in a fast modem if you don't already have one, she said.

Start higher than you want. So you have room to negotiate and still come out ahead.

You must start high and negotiate downward, said Meyeroff. "I have never been thrown out of the office," she said. "I've had a few people say, 'Are you out of your mind?' Most people say, 'That's a little high.'"

Keep a checklist. Figure out what you can "throw away" in exchange for bringing down the price: Fewer hours in-house, they do the research, a not-so-tight deadline, etc.

If they don't accept Meyeroff's price, she says, "I'll go down but what would you like me to knock off?

Recently, a friend was asked to do a 4-page newsletter, for $4,000--a job for which she'd usually charge $6,000. She really wanted to do it because it would be a great portfolio piece, but obviously wasn't going to just lop off $2000. She asked Meyeroff how to get around it.

"I suggested that since it was a pediatrics newsletter, she could use lots of graphics, which meant needing less copy." She also suggested her favorite tactic: "Have the client supply the bulk of the research, provide sources, clips, etc. That cuts down on your time...and time IS money."

Forget Should-a, Would-a, Could-a." If you think you did a good job negotiating, don't beat yourself up about so-called "mistakes." (But by all means learn lessons for the next time.)

"I got everything I want but I'm still unhappy," said Meyeroff. "I didn't get the extra $2,000. But that's still $1,000 a page.

Learn when to say "No."

"Remember, you can always turn a job down," said Meyeroff. "That doesn't mean money's the end-all. People will work for other things, like helping a cause they believe in. But, she asked, "If you're not getting any special benefit AND you're not getting the money you want... why the hell are you doing this job?"